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General NPI Number Information
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NPI Number | 1568103653
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Entity Type | Individual
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Provider Name | STACY HOLMAN
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 324 E WINDSOR DR
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City | DENTON
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State | TX
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Zip | 76209-8312
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Country | US
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Telephone | 940-369-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 4816 CHRISTI LN
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City | AUBREY
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State | TX
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Zip | 76227-4024
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Country | US
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Telephone | 940-595-0364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 14578
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License Number State | TX
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